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Thursday, September 29, 2011

"Before Abraham sacrificed Isaac, he laid himself on the altar - by obeying God."

by Ferenc Visky (Ferenc Visky (July 1, 1918 - October 5, 2005) was a minister in the Hungarian Reformed Church in Transylvania and a leader of evangelical revival in Romania who spent several years in prison under the Communist rule of that country.)

"Take your son... and sacrifice him as a burnt offering."(Genesis 22:2)

God speaks to Abraham and requires something from him. Abraham thinks of everything, except the fact that he has a God who asks something from him.

Nobody is aware that God can also ask for things. People like to ask for things and they like God to give. God asked Abraham to sacrifice his own beloved son and with it, He asked everything from him.

When I was deported together with my seven little children, the eldest of whom was eleven years old and the youngest only two, my biggest concern was not that all our possessions had to be left behind, that the door was closed behind us and that we would not return. The one thing I worried about was the seven little ones. What would become of them? Who would feed them and look after them?

Abraham obeyed and laid his son on the altar, though he did not know God's purpose. He only knew God Himself, for he believed Him and loved Him. Before Abraham sacrificed Isaac, he laid himself on the altar - by obeying God. Because he sacrificed himself first, he prevented the sacrifice of Isaac.

I knew I had to do the same thing. I cried for my children, but I had to lay myself on the altar first. And there, in that fateful situation, I experienced a miraculous surprise. Jesus had been there before. He did His Father's will and so I found that He was there when I was prepared to sacrifice myself and it meant salvation for me and my children.

Don't try to find an excuse when God takes you to the altar, for it is there that He Himself is waiting for you - in His beloved Son.

This is one of those passages that keeps coming up as a theme in our lives, an uncomfortable one, one I'd rather skip over. The most consistently impossible challenge of faith and missions is that of parenthood, of putting our children into situations that seem like an altar, a knife, rope, and bewilderment. I spend a lot of energy feeling like a bit more organization, better feeding, alertness to opportunity, push for language acquisition, more consistent family devotions, more effective prayer, will somehow shield them from the altar. Ferenc Visky and Abraham bear testimony that by asking us to place our children at risk, we are placing our very hearts on the altar. No wonder we balk. But the good news is that God is there. So for all parents of kids at boarding schools, parents of kids who feel lost and out of place, parents of kids with marginal health, parents of kids whose future feels uncertain and threatened, parents of kids who have been teased or isolated or excluded, parents of kids who are taking their own steps of sacrifice and faith . . . remember Abraham.

Wednesday, September 28, 2011

Our chapel speaker this morning read from Ephesians 4: I therefore, as a prisoner of the Lord, urge you to walk in a manner worthy of the calling to which you have been called . . .

And he used as an example Wangari Maathai, who died of cancer this week at age 71. She was a called woman. Here is one paragraph about her life:

"After graduating in 1959, she won a scholarship to study in the US, as part of the "Kennedy airlift" in which 300 Kenyans – including Barack Obama's father – were chosen to study at American universities in 1960. After further study in Germany, she returned to a newly independent Kenya in 1966, and five years later become the first woman in east and central Africa to obtain a PhD from an African university. There followed a tumultuous personal and public 40 years in which she ran the University of Nairobi's veterinary department, was imprisoned several times, stood for president, became a minister and won the Nobel peace prize. . . By this time, the Green Belt was flourishing. What began as a few women planting trees became a network of 600 community groups that cared for 6,000 tree nurseries, which were often supervised by disabled and mentally ill people in the villages. By 2004, more than 30m trees had been planted, and the movement had branches in 30 countries. In Kenya, it has become an unofficial agricultural advice service, a community regeneration project and a job-creation plan all in one." (The Guardian, http://www.guardian.co.uk/world/2011/sep/26/wangari-maathai?intcmp=239)

Wangari Maathai saved some of Kenya's most important forests, because she understood the link between the environment and freedom, between environmental degradation and poverty. She was willing to risk her life, endure beatings and hardship and loss, to stand for what she believed in. And because she did this, an entire new generation of Africans will live better lives.

Wangari Maathai knew her calling, and lived with a passionate single-mindedness that blessed the world. What Kenyan 3-year-olds that I'm treating will be the next Nobel Peace Prize winners? And how can we as missionaries, parents, doctors, live with the same all-out dedication to our calling?

Sunday, September 25, 2011

It's 9 pm on Sunday, and I am very happy to be writing this from BED, the end of a long week, with another one starting too soon. For this hour, though, the cares of Monday are still a sleep away, and I am thankful for this cozy room as the wind whistles down the Rift outside. I confess to ending this week in a bit of a funk, physical (minor viral thing) or emotional (RVA nurse Loren Harrison's sudden death from a hemorrhaging aneurysm in his brain while on a six-month USA stay) or spiritual (allowing the demands of life to eat away at rest and reflection). One of the many small beauties to spring from the blood-soaked soil of Loren's death was a long conversation with another teacher who had been widowed in similar circumstances a few years ago. She told me that God had prepared her heart by leading her to focus on the discipline of thankfulness. So that even hearing about her loss and pain years later, the primary message she communicated to me was thankfulness, for her husband, for the way he died, for their life, for God's mercy. It was very inspiring and convicting in the midst of feeling rather down myself to hear this from her. Today at Loren's service one of his friends read the verse in Proverbs "a merry heart doeth good like medicine" (which Kay Meyer cross-stitched for us years ago) and spoke of Loren's cheerful attitude as the medicine he tirelessly gave his patients. So at this moment let me be thankful. Thankful for life here, for cheering at games as the sun sinks glowing over the Rift Valley. Thankful for Julia the sparkling hostess of our 10th grade Caring Community (monthly small group of students to feed and love), as we produced dozens of pizzas and engaged them in a Cranium game, and popped M and M's and chatted and prayed. Thankful for the 30-some kids who showed up for a prayer breakfast Friday morning, sincere and open. Thankful for the RVA community, as they came together for the memorial service, which was just the right paradox of mourning and celebration. Thankful for teachers like Mr. Batterman volunteering to coach, and doing so in a positive way. Thankful for Mr. Crumley and the choir singing this morning. Thankful that Caleb finally got a chance to lead the weekly fellowship group Koinonia on guitar. Thankful that Caleb and Jack made it through another weekend of games without being seriously injured. Thankful for our old neighbors the Riches lingering over Sunday breakfast and talking about kids and life, thankful for the connection of relationship that goes back more than a decade. Thankful, along those lines, for Anna and Jessica who pitched in with our group on Saturday night when I was almost too tired to stand. Thankful for Sarah and Nathan who took a train up from NYC and spent the day with Luke, a taste of "home" as he put it. Thankful that Caleb is another step closer to finishing his USAFA applications (and trying not to think that then we have to start the "regular" admission parade). Thankful that I'm living with my kids, and heard 3 of the 4 sing in choir this morning. Thankful for an evening jog/walk with Acacia, out on the lip of the valley, with scrub and birds and quiet. Thankful that Scott washed the dishes tonight. Thankful that we got Luke on the phone. Thankful for my washing machine that is churning through the second installment of the weekend's accumulated mountain of dirty clothes (I do love that machine). Thankful that a week from tomorrow we'll be collecting my mom at the Jomo Kenyatta International Airport. Thankful for my happy dog, who gains such satisfaction from any little jog. Thankful that God gives HIs children sleep.

Thursday, September 22, 2011

Our first famine baby to reach Kijabe. Drought and war have interrupted the tenuous cycle of survival in NE Kenya and across her border in Somalia. Food prices have risen dangerously across the region, even though we are a decent distance from the most affected areas. But this week, in the wee hours of the morning, an aid agency dropped this tiny malnourished 3 month old off in our casualty department. Ayub was born in our neighboring chaotic country, 8th child in the family. Three had already died in their first months of life, so this time when his parents saw that he had a defect in his spine and was frail, they decided to trek to Dhaddab, a huge refugee-camp-tent-town on the Kenya side of the border. He was hospitalized there and then transferred to Kijabe wasted, infected, pencil-thin, and irritable, with pneumonia on top of his neurologic and nutritional issues. We stabilized him and began to uncover his underlying problems, which have affected his brain and make his prognosis very poor. But no child should die of hunger, and feeding is one thing we can do while we wait to see what God will heal in the rest of his body.

In contrast, a few meters away, five hundred bright promising multinational children study and play, learn and grow. This is Julia's class last week, and this morning about 30 of them showed up at our house for prayer and cinnamon rolls (a holy combination). They are the future of Africa, and our world, kids with hearts for the poor and with the physical and mental advantages to effect change. At first glance the gap between an RVA student and Ayub seems to be an immeasurably impossible chasm, and we walk the edge between these two worlds, back and forth, hour by hour.

And yet there is a common thread of experience which ties us all together, that of suffering. I think the strong turnout this morning was related to the tragic events of the week at RVA. One of our student health nurses, Loren Harrison, father of 8, died Thursday morning. He was in America this term for a short HMA while his 4th kid started college (3 older are fairly grown, 4 younger are students in elementary to high school). Sunday he had a headache and collapsed, and it turned out that he had massive intracranial bleeding from a cerebral aneurysm (abnormal blood vessel) that had been a dangerous silent threat and then finally burst. In spite of being near a good medical center in MN for care, in spite of being only 51, his life on this earth ended on Thursday. Loren was a man of constant good humor and cheer, who stood in as a father and strength for countless sick students as he worked here for the last decade. This is a small and close community, and such a loss reverberates throughout the students and staff.

We read Romans 8:17 this morning. As heirs of glory we are also heirs of suffering, walking the same path that Jesus did. It always comes as a surprise that godly people who serve others would suffer, even die. Yet if this was required of Jesus, how can we expect anything less?

So today as we prayed for the kids, and as I watch Ayub's mother stranded in this unfamiliar hospital days from home, surrounded by people whom she can not understand at all, I can only ask that the suffering brings us nearer to Jesus, makes us more aware of where He walked, and more complete in Him in the process.

Wednesday, September 21, 2011

. . . World Harvest's newest team, to go with our newest field of Burundi. Today the new team was approved as a group: John and Jessica Cropsey (ophthalmologist and teacher/administrator/mom) with children Elise, Micah, and baby-on-the-way; Eric and Rachel McLaughlin (family medicine and OB/GYN) with children Maggie and Ben; Jason and Heather Fader (general surgeon and teacher/mom) with children Anna and Abi; Alyssa Pfister (Internal Medicine/Pediatrics); and Carlan Wendler. That's 15 new family members in one day. Very sweet. We are incredibly thankful and blessed that God has intertwined our paths, for the world's good and God's glory.

They will now be in a couple of years of support raising and language study before arriving in Burundi to focus on medical care and education in 2013. Get to know them on their blog, and join us in praying for them: http://mccropders.blogspot.com/

Tuesday, September 20, 2011

Who in her right mind would miss a disease that ranks as one of the number one killers of children in the world? Me. I shouldn't, I feel guilty about it, but I confess that I do.

Malaria is deadly. But it is also quite concrete. It can be seen under the microscope. It has a known course, and a cure. A child with malaria can look like death and in a few hours look pretty normal. Malaria is an enemy one can grapple with. We aren't always successful, but we often are. Patients and parents understand it, and want the treatment. You don't have to convince or cajole. The drugs are available, relatively cheaply, and the turn-around is quick.

Which is in contrast to the average Kijabe Paediatric patient, who is complicated and for whom we seem to do little that is dramatic. When I heard that our new admission yesterday was "a 15 month old with diarrhea and dehydration" I thought, great, something we can treat. But of course he had that on top of a progressive depressing divergence from normal developmental milestones, a history of TB with a pericardial effusion, a Rickets-related cardiomyopathy, overall marginal nutrition. This morning he was barely moving, just this side of coma, and we re-checked his potassium level which had fallen from 5 to 2.2 since admission (bad) from his copious stool. The one patient on our service who may have actually come with malaria (from a distant low-lying town) was only here because he also has spina bifida, a VP shunt, a deep pressure ulcer awaiting plastic surgical repair. One of our patients was missing this morning, a darling little 4-year-old girl in a pink headscarf (already) who had come from ICU after being stabilized for new-onset insulin-dependent diabetes. Not the easiest place in the world to raise a diabetic child, but thanks to Mardi's contacts we had a donor who was willing to fund her glucometer and care. Only it seems her father and his relatives did not deem her worth the effort, because about an hour after a long conference convincing them to stay, they ran away with her, and left the bill.

Because we're a referral hospital, and because we have excellent surgeons who are game for attempting the impossible and taking on desperate cases, and because simple things can be treated more cheaply in government health centers, Kijabe is a magnet for the complicated. And often a place where we fail to substantially alter the course of a disease or disability. A place where we bump (crash) right up against our limits.

Which is my real problem, I know. I like to see cures. I like to fix, restore, redeem. It is more appealing to deal with problems we can label, to engage in battles where we can fight back.

Jesus had compassion on the poor, the blind, the lame. I suspect that most of my patients are not so different from those that thronged to Jesus. He healed many, but I don't think he "fixed" everything. The final putting-all-things right still eludes us. The people of the Kingdom are tough cases, complicated, marginal, hungry, lagging, peripheral. Being at Kijabe immersed in these very people should be a taste of Heaven. In fact it just reveals to me that I don't particularly love the needy so much as I love being able to do something about their need.

So pray for people like me, who miss the curable malaria cases, and resent the sense of ineffective futility when confronting our daily stream of those who will never be particularly healthy or smart or strong. Pray for compassion to trump frustration.

Thursday, September 15, 2011

Here we are in Africa, safe and sound, while our extended family battles the elements. My mom's basement flooded for the first time in her 35 years living in that home, after torrential rains in Virginia, something like 15 inches in a few days. By the time she discovered the problem extensive damage had been done, a lifetime's worth of saved memorabilia, boxes, papers, photo albums, clothes, christmas decorations, all damp and moldering, some ruined, some salvageable. She also had some disappointing zoning/financial news about property my Dad left her with rental income to sustain her. So pray for her. Thankful that our dear church friends and neighbors have helped her carry and sort the junk.

Scott's sister and family are in Norway for a year, something like a working sabbatical. So his parents went to visit, and took a cruise ship up the coast. But today their cruise ship caught fire, evidently an explosion in the engine room killed two crew members and several others were burned fighting the blaze. All the passengers were evacuated by lifeboats, wearing life vests. We saw the photos in the news. We've been able to get through to a hotel where they have been taken, but have not talked to them yet. Norway is having a very bad year, and our parents must have been rather frightened. All of their luggage is still on the burning ship.

Luke talked to Marine recruiters visiting Yale this week, and they told him he could sign up for a free helicopter ride. So he did. A 15 minute flight over his school, the city of New Haven, the ocean, with him in the co-pilot seat. Pretty effective recruiting . . and pretty cool opportunity, even if he did miss one class in the process, and even if helicopter rides are a bit dangerous. I've been thinking that if you raise your children in a war zone, and they repeatedly hear gunfire and have to lie on the floor until it stops, and the soldiers they see are good guys protecting them from rebels who have killed people they know, you can't be too surprised if they are attracted to serving in the military. Particularly if tuition is involved. Only we learned today that the Marines don't pay for med school because they don't have doctors, which seems kind of crazy, but I guess they use Navy physicians, or just tough it out.

In a day where almost everyone I love was in danger in some way . . it was good to pray with the Moms In Touch group here, a handful of moms of college-aged kids praying for them and their schools. I appreciate the fellowship of maternal worry and joy.

And my last thought for the day, I really like RVA students. I'm glad I get to see them in clinic every Thursday, and at other times for acute illnesses or injuries during the week. I like teens in general, the way they are finding their way through this world, learning and experimenting and watching and being, seeing things with fresh eyes, challenging. They are interesting. And RVA teens are even more-so to all that. These kids are courageous and creative. Sometimes they are vulnerable and lonely. They are a unique breed, passionate about justice and Jesus and bush living and art and culture, driven to excel because they have purpose, but also still kids who miss home and long for wholeness and peace. I like cheering at their games and listening to them explain their travails in the examination room. I like the taste of the big picture of all that God's people are doing in countries all around us, as I hear from their kids. Of course there are a handful of RVA students I like best of all, my own kids, including the indomitable Acacia.

Sunday, September 11, 2011

Ten years ago today . . . we were in Bundibugyo, the day seemed normal, until friends who were tuned into the ubiquitous local-language radio station told us that America was at war. In those days we had no cell phones, infrequent and poor communication. I remember wondering, was this the beginning of the end, a massive world war that would erupt. On one hand we felt safer in Bundibugyo than our relatives near Washington DC. On the other hand, it was unsettling to imagine all our known world disintegrating, not knowing what was happening to our extended families, feeling stranded. And we were pretty conspicuous as the only Americans for many many miles in any direction, in a district already known for rebel activity from an Al-Qaeda trained group. It was not until weeks later that we saw the unbelievable images that everyone else watched on September 11th (sent on VHS tape in the mail from friends). We did have a satellite radio and I remember all gathering to listen, and to pray. But for once, we were in a SAFER part of the world.

Ironically, today on the 10-year anniversary, a google-alert popped up in our email. Wikipedia added an entry today on Bundibugyo ebolavirus. What appropriate timing, linking disasters. All the world ebola epidemics combined have not killed as may people as 911. Yet the two, 911 and ebola, have much in common. Unstoppable, random, destructive violence, frightening in its sheer evil.

On this day, it is hard to deny the existence of evil. And even harder when one spends the entire day battling it. 4 am, beeper goes off, power is out, stumble through the house to find a light to see what is happening . . 6 am phone rings, our tiniest preemie is not breathing. I spend several hours hovering over this 1 1/2 pound fragility, and call everyone I know for help, and end up jamming the smallest endotracheal tube I can through his tiny glottis with some damage. I pretty much give up on a happy ending to this story, bring his mom in to hold him (another lady with no living child after several pregnancies), and then for want of anything better to do put him back in his incubator on oxygen by cpap as I rush off to another critically ill baby in the casualty department at 9. This new child consumes the rest of the morning, stridorous, cold, shocky, poorly perfused, marginal. Thankfully there is an ICU bed, and as I'm reviewing his very abnormal labs that don't quite fit together and make sense, I wonder if he has congenital adrenal hyperplasia, and look up the treatment. I pass back by nursery and the tiny preemie is, miraculously, still alive. Off to the ward to check on those patients, back to ICU, back to nursery to see a newly admitted baby who sucked in a bit of meconium in the birth process, and just as it looks like I might get to go home we get a call that the OB team is taking a 32-weeker to C-section. The mom is in her 4th pregnancy after 3 early losses, and now she's in labor, with a foot presenting. I watch the intern struggle (and I mean struggle) to extract this baby (it turns out the mom has an anomaly of the uterus) and by the time he pulls this girl out she is limp, pale, lifeless. By the time we start to give her breaths we lose her heart rate. I don't think I can face another desperately bereaved mom. But a few minutes of CPR and we have her back, and we set her up with all available therapy. It's now 3:30 and I have yet to drink, sit, eat, or take a personal moment since dawn. Meanwhile Scott plows on through his call too, intubating a trauma patient, consulting on the unstable adults. A lot of evil out there today, grabbing at defenseless babies and elderly refugees alike.

So this evening, in an hour of quiet between running back and forth to the hospital and giving minimal attention to kids and dinner, I pause to remember 911. And to remember, we are in a war, a war against evil, not against people of any particular ethnicity or cultural background. A war against the evil diseases that plague our patients, not against the patients themselves (though we can feel beaten down in weariness by this time on a weekend call). Grant W from WHM posted a link to a Christianity Today article by Russell D. Moore, called the Gospel at Ground Zero. In it Moore argues that the legacy of 911 is the reality of evil, the insistence that we not gloss over it or package it in muted form:

Where there are no demons, we demonize. And without a clear vision of the concrete forces we as the church are supposed to be aligned against, we find it very difficult to differentiate between enemy combatants and their hostages.

The Scriptures command us to be gentle and kind to unbelievers, not because we are not at war, but because we're not at war with them (2 Tim. 2:26). When we see that we are warring against principalities and powers in the heavenly places, we can see that we're not wrestling against flesh and blood (Eph. 6:12). The path to peace isn't through bellicosity or surrender, but through fighting the right war (Rom. 16:20).

Saturday, September 10, 2011

First, a story of the kind of miracle that happens at places like RVA. And more often than we notice, I'm sure. Today was outreach day, where groups of students go out into the community to serve in various ways, from orphanage visits to trash pick-up. One group planted trees and was attacked by a swarm of bees. I talked to the nurse who received them back in the infirmary, and she estimated that at least 15 girls and both staff members accompanying them had multiple stings, some up to 20 on one person. BUT . . . the only two kids who were not stung were the only two kids with severe allergy to bee stings.

Julia and Acacia also planted trees, but in a different place, at a primary school in old Kijabe town. Which is pretty cool for at least two reasons. Acacia planting acacia trees in her new home country of Kenya, and Julia planting any trees anywhere because she has a particular affinity for trees, and has read Wangari Maathai's autobiography (amazing Kenyan woman who won the Nobel Peace Prize for the Greenbelt Movement to reforest Kenya).

Caleb's varsity soccer team went to a prison in Naivasha and played a match against the inmates. Which seemed to be fun, though I'm just glad that no one was injured, as I think of grown men and a walled compound and a dirt pitch . . . Jack's JV soccer team stayed here and played against a team from the on-station Moffat Bible College, young African aspiring pastors, which is sort of an ironic contrast to the prisoners I guess, and afterwards they had lunch together. JV won 4 to 2, with Jack scoring both of the second half goals. Which is sort of amazing because he was clearly frustrated with himself and not playing his best first half, and Scott gave him a half-time pep talk. So I guess it shows that Scott knows how to give half-time pep talks.

Scott and I are both on call, and paediatrics has been eerily calm. Scott however is covering ICU as well and though the day was quite reasonable he's dealing with a victim of a road traffic accident now. His highlight today was sending home a young woman after a month of antibiotics cured her of a brain abscess incurred when her husband tried to kill her with a machete. Our 650 gram 25-week preemie is alive and breathing, and today started on the whopping amount of a half a cc of milk every two hours. Interesting case of my week, a 3-year-old who was admitted with ascites (fluid in the abdomen) that turned out to be secondary to abdominal TB, and a 6 year old who was admitted multiple times in his life for vomiting, whom I didn't take seriously as he looked quite well until I SAW the basin full of fluid he threw up ... who turned out to have lived all those six years with an intestinal malrotation. Thankful for our paeds surgery partners!

And this week, we are glad to be safely in Africa rather than DC! My mom has had an earthquake, a hurricane, zoning issues which threaten her livelihood, then massive flooding that seeped into her basement for the first time ever, not to mention the high alert for terrorist attacks tomorrow. Kijabe seems rather calm by comparison.

Lastly, we made pizza in our new oven Friday night. A few neighbors stopped for tastes as they walked by, and we roped one young lady in for the evening, plus our WHM team mates Jessica and Anna, so it felt almost like a Bundibugyo evening. Only cold. And no obekekuni. As we always say, there's a reason a hundred missionary families live here, and one in Bundi.

After an spiritually and emotionally draining week, I'm thankful for the weekend, even if we are on call. And Man U is winning to boot.

Thursday, September 08, 2011

Because at 3 this morning, I was awakened by a phone call. The intern said, "I have some sad news from nursery". In my bleary state I thought he said some sodium results, since the only unstable baby was a dehydrated one . . But then he went on to tell me that Shunetra had died.

Yes, Shunetra, the poster child of hope.

Dead.

I was stunned, unbelieving, speechless, and grieving. By the time I walked over to the hospital the chaplain had also arrived, and I heard Shunetra's mom Esther weeping as soon as I opened the door to the maternity ward. I went straight to her bed and hugged her and started crying myself, while the calm and sober chaplain Sylivia sat on her bed and rubbed her legs. The first words from her mouth were, between sobs, "I thought I was a good mom, but why did God take my baby?"

Why, indeed?

Why did she lose her first child as a stillbirth at 8 months last year? Why then did she have severe complications and have to deliver this one at 7 months this year? Why did she spend over two months (almost three) in intensive care with this baby, hoping against the odds? Why did she come so close to victory, only to have all her dreams snatched away at the last moment? Shunetra was allowed out of the NICU to stay on the maternity ward with her mom on Monday. She was officially discharged on Wednesday. She had stayed two extra nights because she couldn't pay the balance of the bill not covered by her insurance (nearly 3 months of intensive care and surgery had come to over 3 thousand dollars, of which 2 thousand was covered . . which I'm sure one could spend in one day of NICU in the states, but here it's a lot of money, and we were contacting a charitable group in Germany who sometimes helps kids like this). She was full of plans and dreams, ready to take this precious baby home, ready for a new life as a mother. Now she has lost it all.

Esther is a high school teacher. She is articulate and competent. She was fully committed, unwavering. She bought her own thermometer to monitor Shunetra's temperature when she moved out of intensive care and had less nurse supervision. She knew what she was doing, after those months in the NICU day and night she had experience, and she saw no signs of illness. Shunetra breast fed avidly at 10 pm, had a normal temperature, a diaper change, and fell asleep, so Esther did too. It wasn't until she woke at 1 am and realized the baby had not cried as she always did at midnight, that she realized anything was wrong, and by then it was too late. When she ran hysterically with the baby into the nursery, the nurses report that Shunetra was cold and stiff and long dead.

If there is anything to be learned from Job, this is the time to apply it. Esther is a modern day Job, a righteous woman, who in spite of faith and hard work and encouraging others and prayer, lost all that was precious to her. I should have sat in silence for a week, but on the relative scale of my life, it was about an hour, of tears and listening. Then what could I say? We can't explain God. He allows suffering that we would not choose, that makes no sense to us. If there is anything we can see in Shunetra's death, it is the enormous horror of Evil. Evil with a capital E, Evil that stalks the innocent, that sucks life, that disrupts and steals, that then whispers doubt and blame. Satan, not God, attacked Job and now Esther, and there is no glossing over the putrid terrible reality of this wrong.

God did not block this particular move in the battle for the world. So we cry and ask why, as Job and David and many others have done.

After the why, then what? Job said "I know that my Redeemer lives, and in my flesh I shall see God." There is nothing to justify or soften the blow, but there is still truth. Truth that this is not the end of the story. Truth that Shunetra and Esther will be seated, in new incorruptible flesh, at the banquet of the Lamb, reunited and whole. Truth that the God who allowed this death also allowed the death of His own son, because Evil is that pervasive and terrible, that costly to conquer. Truth that God is God, and we are not. That His ways can not be boxed and categorized neatly according to our sense. That in this world we see the weak and innocent pay dearly, but that there is more than what we see.

Esther will go home empty-handed, bruised and beaten, devastated. Perhaps in a year or two she will risk breaking her heart for the third time, perhaps she won't be able to. It is actually the second night this week that I've gone in at 3 am for a non-revivable baby, the second time we've been unable to rescue one living child for a multiply-bereaved mother. We will push on day after day, fighting back, but I have to be honest in saying that that anchor of hope feels too light to hold anything in place today.

I don't think of hope as a weighty substance. Perhaps courage has weight, or determination, or even passion. But hope sounds ephemeral, fleeting, insubstantial, tenuous. So the verses we read in prayer meeting this morning jumped out: we have this hope as an anchor (Heb 6). Last month we rode a traditional wooden dhow through the Indian ocean surf, anchoring off an island for lunch, and near a coral reef for snorkeling. The anchor involved was solid, barnacled, a definite substance, straining the muscles of our crew-man as he threw it over the side. The weight of it carried it down to the ocean floor, and our attachment to it held us in place. Instead of drifting with the tide we remained secure. We couldn't see the anchor anymore, but it did its work below the surface of the ocean.

So tonight I'm thinking more about the heaviness of hope. Hope as a solid, tangible thing, a thing of weight and drag, to hold onto, in the currents of life. A thing that pulls on our hearts steadily, unseen, keeping us from wandering, attaching us to the Rock.

In fact, I think hope weighs more than most of my patients do. Today Shunetra was discharged from the hospital. She came into this world precipitously a couple of months ago, less than two pounds. There was not much to anchor her to this world other than her mother's hope. I remember meeting her mother pre-delivery to explain what we could do in the nursery, she was admitted with life-threatening complications of pregnancy, and had to be delivered before both she and her baby died. She had no living children, this was her last chance. We gave the baby everything we could, but her prognosis looked soberingly grim, and I remember her mother's tears. But this lady also had hope, and one day I met a group of her friends who had come to pray through the nursery windows. Shunetra was not a star preemie. Most things that could go wrong, did. One night I was on call, and I spent hours in the NICU with her on a heated bed, giving her artificial breaths, hoping she would live. I hated to face her mother if she died, but I pretty much had resigned myself to that. After many attempts at reviving her, she was not really responding. So I prayed aloud with the nurses over her one last time, and said we will resuscitate her again, and if she doesn't start breathing, we will have to let her go. And then, miraculously, she did. All night, one hopeful breath after the other. That wasn't her last brush with death, she also had surgery on both knees for infections (she must be one of the tiniest ever in the orthopedic surgery theatre). But that mom's hope anchored Shunetra firmly to life, and she fought on and on, all the way up to a whopping four-plus pounds, ready to face the world outside.

Tonight hope, in my mind, weighs four pounds. And as I pray for my own kids I ask for this kind of hope to anchor their souls and mine. To be a tether in a choppy world where it is too easy to be pushed far out to sea, or thrown against the rocks. Compared to Shunetra they look amazingly solid, but in my heart I see the gaping future, the uncertainty, the danger. The desire for friendship, the quiet perseverance through hours of work, the plodding, the work of fitting in and making friends. And the imminence of each leaving this harbor, the nausea of being out in the wildness of the storm and holding on for dear life.

Wednesday, September 07, 2011

FACT: Most of the dangerous places to be a less-than-five year old child are in Africa.
FACT: Though Africa represents about 15% of the world's population, more than half of all childhood deaths occur here.FACT: Almost all of these deaths are preventable with good maternity and neonatal care, a few antibiotics, clean water, mosquito nets.
FACT: Jesus cares about the least of these. Hard to remember sometimes in the thick of it, like at 3 am this morning when I was awakened to assist with the anticipated delivery of an extremely premature baby. He came out mottled and stiff, dead for some hours. Which is sad enough, only this was this mom's third pregnancy, third C-section, and third dead baby.
FACT: The infants cry out for justice, God is listening, and that's why some of us end up where we do. I think there's room for thousands of more pediatricians in Africa. Come.

Sunday, September 04, 2011

I take zero credit for the crafting soul of this child . . Joanna taught her to crochet, and today she used the last of the yarn we brought from America making this scarf. Just in time for a cool rainy night. Julia is also holding a stuffed-animal ladybug she made, which she named "Judy" in honor of Grammy, and is to be a gift for a friend tomorrow. Before Luke left she made him a new crocheted cap, which will be essential in surviving the winter at Yale. So thanks Joanna, and mom can you bring more yarn???

Thursday, September 01, 2011

Slow, and thanks, are two words that sifted into consciousness at our field retreat. Being present in the here and now, and thankful for it. So in a week of a bit of chaos (ten living in our small house, fifteen one day, new books and notebooks and pens and classes times four high-schoolers, covering extra work in the hospital due to colleague sickness, keeping up with bread production and food preparation and laundry for the crowd, Caleb trying three nights to skype interview for the Air Force Academy before it finally worked, feeling like the emails are out of control so I counted one day's worth last night and quit at 132, new students with new health issues and the usual fevers and injuries and rashes and worries, trying to connect with one kid on the other side of the world, you get the picture) I am pausing this morning to remember slow thanks.

Jen G posted a quote on fb: what if you woke up tomorrow and only had what you gave thanks for today? Sobering. Thanks was the theme of my devotional reading this morning, too. So I am reminded to be thankful, for this cup of warm milky Kenyan tea, for this comfortable peaceful home, for four kids off to class this morning with brains and book bags tumbled full of integers and English essays and Swahili vocabulary. For Luke getting into a required but full English seminar. For Julia and Acacia joining Caleb in choir; 51 new kids tried out for limited spots. For Mr. Crumley, the choir director, whose pastoral heart draws, as evidenced by the fact that about 1/5 of the high school is IN choir and another 1/4 would LIKE to be. For Jack and Caleb surviving the first round of cuts in soccer tryouts, again 60-plus boys all trying their hardest. For coaches who enable three teams for boys' soccer and girls' basketball, meaning my kids and others have an opportunity to learn and run (and I mean run, Caleb has placed second amongst the 11th and 12th graders in the 1 to 3 mile runs, and Jack also placed second amongst all the 9th and 10th graders!). For the Massos' courage and sacrifice, leaving their daughter with us, a holy privilege, deeply serious. For our WHM colleagues spending the month at Kijabe, the ever cheerful can-do Miss Anna substituting in World HIstory and Government for a teacher who is missing the first few weeks of the term, and the tenderhearted Dr. Jessica who not only kept a newborn alive with expert resuscitation while she called me to come in the early morning hours but then donated her own blood to save the life of the post-partum bleeding mother. For connection with God's Kingdom in scattered outposts of Africa as parents bring their children here, for our tiny supporting role in this complex picture. For my partner and friend Dr. Mardi, whose wisdom and work means I have time to inhale, to ponder, to thank.

And time to slow down. Another theme of our meditation was to live in the present, not to treat the present as a temporary anomaly between what is past and what will be. My reading this morning brought me to Exodus 24 again, a really remarkable chapter, particularly after actually visiting Mt. Sinai and thinking about the feast for the seventy elders, the substance of the heavens paving stones to the Throne. And the six days of thick cloud that preceded Moses' encounter with God. Dan remarked that sometime in his life he hoped to spend six silent days waiting for God to speak. I tend towards a frantic pace, cramming and quick, as if that would then buy me slow time later. But I need to grasp that this is the life we have, currently, not as a next-best-thing to what was, or a get-yourself-ready for what will be, but for NOW. Some of my favorite hours of the last year have been spent on the sidelines of sports matches, which sound rather trivial in the big picture of eternity and the relentless battle for the restoration of creation. But I think those hours are precious because they are rare slices of the present. When we cheer our kids, we are there, not thinking about the past or future, fully engaged in the here and now, enveloped in a community doing the same. Along with meals, slow fellowship of the table, and worship, these are the places that the pace of real life (eternal life) breaks in.

There will be many moments in the next week that will be hurried and worried. I'll be faced with a long list of patients or be pushed to action by a breathless baby; I'll be multitasking in the kitchen to pull together sustenance before some scheduled event. But this morning I am practicing slow thanks. Which is, in the end, merely another way of saying faith. Remembering that more action from me, or better ideas from me, are not needed, because God is in control, and all manner of things shall be well.

Our Mission

who we are

paradox:
1. something that combines contradictory features or qualities.
Life in Africa is full of contradictions - the beauty and pain; the abundance and the poverty; the joy and the sorrow.
Our lives, too...dying that we might live; strong in our weakness; sinners yet saints.
2. a "pair of docs"